左室压力-应变环技术早期诊断脑-心综合征的应用研究

Research on Application of Left Ventricular Pressure-Strain Loop Technique in Early Diagnosis of Cerebral-Cardiac Syndrome

目的:分析应用左室压力-应变环(LVPSL)技术早期诊断脑心综合征(CCS)的价值。方法:随机选取自2020年8月-2021年7月于山东第一医科大学附属滨州市人民医院就诊的出血性脑卒中患者56例,入院12 h内行超声心动图检查,并用LVPSL技术行左室做功分析,根据患者7 d内是否并发CCS分为病例组(27例)和观察组(29例),回顾性分析两组患者左心室整体纵向应变和左室心肌做功参数指标。结果:与观察组相比,病例组整体无效功明显增高,差异有统计学意义(P<0.05),左室心肌整体纵向应变、整体做功指数、整体有效功、整体做功效率明显降低,差异均有统计学意义(P<0.05)。ROC曲线显示左室心肌整体纵向应变、整体做功指数、整体有效功、整体做功效率、整体无效功的曲线下面积分别为0.11、0.64、0.12、0.70、0.02,整体无效功诊断CCS的截断值为81%,其灵敏度为95%,特异度为68%,约登指数0.63。结论:LVPSL技术在CCS的早期诊断中有参考价值。

Objective: To analyze the application value of left ventricular pressure-strain loop (LVPSL) technique in early diagnosis of cerebral-cardiac syndrome (CCS). Methods: A total of 56 patients with hemorrhagic stroke admitted to Binzhou People's Hospital Affiliated to Shandong First Medical University from August 2020 to July 2021 were randomly selected. Echocardiography was performed within 12 hours after admission, and left ventricular work analysis was performed using LVPSL technique. According to whether the patients developed CCS within 7 days, the patients were divided into case group (27 cases) and observation group (29 cases). The left ventricular global longitudinal strain and the parameters of left ventricular myocardial work of patients in two groups were analyzed retrospectively. Results: Compared with the observation group, the overall ineffective work in the case group was significantly increased, and the difference was statistically significant (P<0.05), global longitudinal strain, global work index, global effective work and global work efficiency were significantly decreased, and the differences were all statistically significant (P<0.05). ROC curve shows that the areas under the curve of left ventricular global longitudinal strain, global work index, global effective work, global work efficiency and global wasted work were 0.11, 0.64, 0.12, 0.70 and 0.02 respectively. The cut-off value of global wasted work for diagnosing CCS was 81%, its sensitivity was 95%, specificity was 68% and Youden index was 0.63. Conclusion: LVPSL technique has reference value in early diagnosis of CCS.